Revenue Cycle Claims Billing Analyst

Become a part of our caring community and help us put health first

As the Revenue Cycle Claims Billing Analyst
, you will ensure accurate and efficient billing processes across the organization. The main responsibilities you will be responsible for include daily monitoring of accounts receivable and claim submissions, identifying and resolving billing errors, and addressing claim rejections. You will also research billing issues and recommend process improvements.

• Update the A/R pivot table for daily review of accounts receivable status.
• Review recently submitted claims to identify and resolve issues with uploading to Rev Connect, including mass rebilling for claims not transmitted.
• Identify opportunities for billing project improvements and resolve similar billing issues.
• Review Non-Medicare payers in Rev Connect to detect and correct mass billing errors causing claim rejections.
• Ensure root causes of rejections are resolved to prevent continued issues.
• Help research billing issues to determine and implement appropriate resolutions.
• Monitor new payer Quick Reference Guides (QRGs) and contract updates to ensure payers are paying according to contract terms; resolve any discrepancies.
• Track week-over-week trends for billed and unbilled accounts.
• Monitor for significant billing issues that may affect revenue collection.
• Identify solutions to reduce aging accounts (over 90 days) and achieve main indicator targets.
• Track month-over-month trending to identify opportunities for improvement in billing, procedures, and collections to support organizational goals.
• Monitor and report on over 90-day aging trends to resolve denied claims and increase revenue.
• Track the top 10 monthly payers and comment types to identify and resolve any increases in billing or claim issues.
• Provide detailed reporting and analysis as requested by management.
• Help with audit reviews.
• Review contracts for accuracy and compliance in claim processing when needed.

• Minimum of 5 years of experience in billing systems, payer setup, and contract review.
• Proficiency in data analysis and reporting.
• Data-driven decision-making experience.
• Attention to detail and organizational abilities.

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

40

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$60,800 - $82,900 per year

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and…